House Health Care Bill: Its Path and Transparency


Yesterday, the House of Representatives released a 1,018 page bill (H.R. 3200) to reform the nation’s health care system. This is the first step in the House in the long slog to pass health reform. The bill will go through many different steps, committees, markups, hearings and floor procedures before it comes out the other end. In this post, I will try and explain all of these steps while also detailing the areas where transparency problems may arise. At Sunlight, we’re trying to make sure that transparency in the entire legislative development of this bill is taken as a paramount concern by Congress.

The bill begins its journey when it is referred to committees with jurisdictional authority. In this case, there are three committees with direct jurisdiction over the health care reform bill: Education & Labor, Energy & Commerce and Ways & Means. Beginning this week, all three committees will hold markups on the bill. While the committees have slightly different jurisdictional authority — Ways & Means covers tax provisions, Medicare and Medicaid and Education & Labor covers workplace protections — they will all discuss the central, and most controversial, piece of health care reform, the public option. From the announced schedules of the committees (see the bottom of this post), the bill will be in Energy & Commerce for the longest period of time.

Transparency issues are bound to come up during these committee markups. The most pressing issue is the disclosure of amendments to be offered in committee during the markups. Will the amendments be disclosed prior to voting? During voting? Amendments should wind up in committee reports, along with the vote tallies — barring a voice vote, which is not recorded — but sometimes these are not posted to the committee web sites. The three committees should consider making this process as open as possible by providing a list of amendments offered online. The Rules Committee does this and I don’t see why these committees couldn’t do it too. (I’m told from independent sources that Ways & Means may be the worst committee for transparency, as they have yet to get proactive about posting materials to their web site as the other two committees have.)

The real problem, as it relates to transparency, will arise once the tri-committee markup is complete. The likely outcome of the tri-committee markup is that there will be competing versions of the bill that will need to be reconciled between the committee chairs, leadership and wayward Democrats seeking to influence the bill. This is exactly what happened with the cap and trade bill. The reconciliation between the committee chairs will not be done in open session and could result in a very different bill than the one that came out of the three committees. That being the case, there are good reasons to believe that a committee chair reconciliation will not result in the same outcome as the cap and trade bill. Here’s why:

The issue with cap and trade was that only Energy & Commerce held hearings on the bill. The bill was never considered in open session before the other eight committees with jurisdiction. Instead, the committee chairs met and hashed out a compromise behind closed doors and released a different bill that wasn’t even complete. Unlike this process, the health reform bill will be reviewed in open session in all three committees and copies of the marked up bill language should be available, although perhaps in less than ideal quality, for the public to see and read. Thus, there shouldn’t be as many surprises as the cap and trade committee compromise brought.

So, what happens after the committee chairs get together and put their versions of the bill together? The bill needs to go through one more committee: the Rules Committee. In a Rules Committee session the members will consider amendments to be offered during debate on the floor of the House. The committee will likely review over 200 amendments, rejecting most and allowing only a few. There is also the possibility that a manager’s amendment will be considered, much like the cap and trade bill. The Rules Committee has been historically notorious for its lack of transparency. Lately it has been better than many other committees in disclosing committee amendments and reports online, but sessions are sometimes held late in the day, often going late into the night. The committee room is also not equipped with video equipment to televise the hearings online.

Finally, the bill will reach the floor of the House for consideration. This is pretty self-explanatory and will likely feature votes on amendments, a vote on a motion to recommit and a final vote on passage. All will be televised.

Below is the announced committee schedule:

July 15: Education & Labor holds first markup. Only opening statements made.

July 16: Education & Labor continues markup with introduction of amendments and voting. Energy & Commerce begins markup (2:00 pm). Ways & Means begins markup (9:00 am).

July 17: Energy & Commerce continues markup.

July 20: Energy & Commerce continues markup.

July 21: Energy & Commerce continues markup.

July 22: Energy & Commerce continues markup.